An assembly can include a delivery apparatus, a crimping device, and a loading assembly. The crimping device can include a housing disposed over a first shaft of the delivery apparatus and configured to receive a radially expandable and compressible prosthetic valve in a radially expanded state. The housing can have a funnel segment extending at least partially along the housing and an outlet. The crimping device can further include a pusher member and an actuator releasably coupled to the pusher member, wherein advancement of the actuator relative to the housing causes the prosthetic valve to move through the funnel segment to compresses radially by engagement with the funnel segment and exit the crimping device via the outlet. The loading assembly can include a support tube disposed over a second shaft of the delivery apparatus and a funnel member disposed over a first end portion of the support tube.
A docking station frame for a medical device includes a plurality of strut portions extending from a proximal end to a distal end and forming a plurality of cells.
Disclosed herein is a textile (30) comprising: a) a first yarn (102, 112) comprising one or more filaments comprising a first polymer; b) one or more additional yarns (104, 106, 108, 110, 114, 116, 204, 214, 304) comprising a composition and/or properties different from the first yarn (102, 112); wherein the first yarn (102, 112) exhibits an elasticity higher than an elasticity of the one or more additional yarns (104, 106, 108, 110, 114, 116, 204, 214, 304), the textile (30) exhibits an ultimate elongation of about 50% to about 700% and is shape-adapting and biocompatible, and wherein the textile (30) is configured to be inserted and/or implanted in a subject's body. Also described herein are medical devices (10) having the disclosed textiles (30). In addition, disclosed herein are methods of making the disclosed textiles (30).
D04B 1/18 - Autres tricots ou articles caractérisés principalement par l'emploi de matières spéciales pour le fil fils élastiques
D03D 15/56 - Tissus caractérisés par la matière, la structure ou les propriétés des fibres, des filaments, des filés, des fils ou des autres éléments utilisés en chaîne ou en trame caractérisés par les propriétés des filés ou des fils élastiques
A docking station for a prosthetic implant includes a frame. The frame includes one or more tissue engaging elements, which is some examples are apices of the frame formed by struts of the frame. The frame and/or the apices can be configured to engage native tissue at an implantation location to retain the position of the frame without damaging the native tissue. A docking station can also include a sealing skirt and/or a protective cover coupled to the frame. The sealing skirt can reduce retrograde blood flow through and/or around the frame. The protective cover can reduce damage to the native tissue.
A delivery apparatus includes a handle body, a carriage, a first shaft, a second shaft, and a drive member assembly. The handle body includes proximal and distal ends and a cavity disposed between the proximal and distal ends. The carriage is disposed within the cavity and is axially movable relative to the handle body. The first shaft has a proximal end fixed relative to the carriage. The second shaft extends through a lumen of the first shaft and is fixed relative to the handle body. The drive member assembly includes a knob and a plurality of body members. The knob and each body member are formed as separate components. The drive member assembly is coupled to the carriage and the handle body such that rotating the knob relative to the handle body moves the carriage and the first shaft axially relative to the handle body and the second shaft.
A delivery apparatus (300) for delivering a prosthetic implant (200) includes a handle body (304), an outer shaft (309), and an inner shaft (305, 600). The handle body includes a proximal end (308), a distal end (312), and a longitudinal axis (315) extending between the proximal end and the distal end. The outer shaft includes a proximal end movably coupled to the handle body. The inner shaft extends through a lumen (313) of the outer shaft and is fixed relative to the handle body. The inner shaft includes a first reinforcement layer (604) and a second reinforcement layer(606). The first reinforcement layer extends from a proximal end portion of the inner shaft to a first distal location of the inner shaft. The second reinforcement layer extends from the proximal end portion of the inner shaft to a second distal location of the inner shaft, and the second distal location is proximal to the first distal location.
A61F 2/95 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes
A61F 2/962 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure
A clip (30) maybe configured to close the portion of the heart, to reduce blood flow therethrough as well as passage of clots or other undesired materials. The clip may be configured to close the left atrial appendage (LAA). The closure of the LAA may reduce the possibility of stroke or other maladies stemming from fluid flow with the LAA. The clip may include a first jaw (32) with a compression surface facing a compression surface of a second jaw (34).
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
The expandable sheaths (100) disclosed herein have a plurality of radially arranged layers, including an inner liner (102), a first polymeric layer positioned radially outward of the inner liner, a braided layer (104) positioned radially outward of the first polymeric layer, a second polymeric layer positioned radially outward of the braided layer, and an outer liner (108) positioned radially outward of the second polymeric layer. The sheath comprises a plurality of longitudinally-extending pleats in a collapsed (unexpanded) configuration, and the longitudinally-extending pleats incorporate the plurality of radially arranged layers. When a medical device is passed through the sheath, a diameter of the sheath locally expands around the medical device while the first and second polymeric layers resist axial elongation of the sheath such that a length of the sheath remains substantially constant. The sheath resiliently collapses after the passage of the medical device.
A valve repair device for repairing a native valve of a patient. The valve repair device includes a paddle, a gripping member, and an indicator. The paddle and/or the gripping member are movable to form an opening or capture region between the gripping member and the paddle. The indicator is configured to indicate whether a leaflet of the native valve is inserted into the opening or capture region between the paddle and the gripping member to at least a minimum insertion depth.
A sensing valve repair system includes a delivery system and a heart valve repair device. The delivery system is configured to deploy the heart valve repair device. The sensing valve repair system has a first sensor associated with one or more of the delivery system and the valve repair device. The first sensor is configured to sense a characteristic in a heart atrium. The characteristic sensed by the first sensor can be sensed proximal to, or at a proximal end of, the valve repair device. The sensing valve repair system has a second sensor associated with one or more of the delivery system and the valve repair device. The second sensor is configured to sense a characteristic in a heart ventricle. The characteristic sensed by the second sensor can be distal to, or at a distal end of, the valve repair device.
Valvular regurgitation is addressed by implanting devices at or near a native valve to treat leaflet issues, such as prolapse or flail. This can be done by treating the leaflets and/or by treating one or more natural chordae tendineae (chords). Treating the leaflets can include methods and devices that inhibit or arrest the leaflet from billowing and/or flailing into the atrium, that influence the leaflets to coapt, that take up excess tissue, and the like. Treating the chords can include methods and devices that shorten chords, that increase tension in the chords, that attach chords to the ventricle wall or to each other, and the like. In each of the disclosed methods and devices, coaptation is increased and/or valvular regurgitation is reduced. The disclosed devices and methods can be performed on a beating heart.
A method of and system for non-invasively measuring tissue hemoglobin of a subject is provided. The method includes: a) non-invasively sensing tissue of a subject using a near infrared spectrophotometric (NIRS) sensing device, and determining at least one NIRS tissue THb value based on the non- invasive sensing; b) determining whether at least one Hb confounding factor is present during the non-invasive tissue sensing with the NIRS sensing device; and c) determining a NIRS circulatory THb portion of the NIRS tissue THb value based on the presence of the at least one Hb confounding factor during the non-invasive tissue sensing with the NIRS sensing device.
A61B 5/145 - Mesure des caractéristiques du sang in vivo, p.ex. de la concentration des gaz dans le sang, de la valeur du pH du sang
A61B 5/00 - Mesure servant à établir un diagnostic ; Identification des individus
A61B 5/1455 - Mesure des caractéristiques du sang in vivo, p.ex. de la concentration des gaz dans le sang, de la valeur du pH du sang en utilisant des capteurs optiques, p.ex. des oxymètres à photométrie spectrale
A61B 5/1495 - Mesure des caractéristiques du sang in vivo, p.ex. de la concentration des gaz dans le sang, de la valeur du pH du sang Étalonnage ou test des sondes in vivo
13.
HEART VALVE REPAIR DEVICES AND DELIVERY DEVICES THEREFOR
An implantable device or implant is configured to be positioned within a native heart valve to allow the native heart valve to form a more effective seal. The implantable device or implant can include a paddle frame that is adjustable in width. A coupler can be configured to allow for width adjustment of the paddle frame and to set or fix the width of the paddle frame. A cover can be configured to prevent or inhibit regurgitant blood flow regardless of the selected width of the paddle frame.
A method comprises delivering a medical implant and a delivery device to a tissue wall within a heart of a patient. The delivery device can be attached to the medical implant. The method further involves maneuvering the delivery device to place at least a portion of the medical implant at a desired position with respect to the tissue wall and delivering an expandable stagnation device proximate to the medical implant. The expandable stagnation device is configured to at least partially inhibit blood flow. The method further involves injecting a contrast solution between at least a portion of the medical implant and at least a portion of the expandable stagnation device, collapsing the expandable stagnation device, and detaching the delivery device from the medical implant.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A61B 17/12 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical
A sheath assembly can comprise a removable hub. The removable hub can have a lumen extending therethrough and comprise a first circumferential hub portion that spans a first circumferential segment about a longitudinal axis of the removable hub, a second circumferential hub portion that spans a second circumferential segment about the longitudinal axis of the removable hub, and first and second connector portions connecting the first circumferential hub portion and the second circumferential hub portion. The second circumferential segment can be greater than the first circumferential segment. The sheath assembly can comprise a removable shaft configured to extend distally from a distal end of the removable hub, the removable shaft being configured such that separation of the first circumferential hub portion from the second circumferential hub portion causes a first circumferential shaft portion to separate from a second circumferential shaft portion.
Aspects of an expandable sheath can be used in conjunction with a catheter assembly to introduce a prosthetic device, such as a heart valve, into a patient. Such aspects can minimize trauma to the vessel by allowing for temporary expansion of a portion of the introducer sheath to accommodate the delivery apparatus, followed by a return to the original diameter once the prosthetic device passes through. Some aspects can include a sheath with a tubular inner liner (3200) wound in a spiral configuration at least a portion of the outer surface of the sheet comprises a plurality of bonding sites (3220) that are at least partially embedded within the sheet and disposed such that the outer surface of the sheet in the overlapping portion is substantially free of the plurality of bonding sites. The disclosed sheath is configured to expand from a predetermined rest diameter d r to an expanded diameter d e during application of a radial outward force by passage of a medical device through the sheath.
A61L 31/12 - Matériaux composites, c. à d. en couches ou contenant un matériau dispersé dans une matrice constituée d'un matériau analogue ou différent
A61L 29/12 - Matériaux composites, c. à d. en couches ou contenant un matériau dispersé dans une matrice constituée d'un matériau analogue ou différent
17.
LEAFLETS AND LEAFLET SEPARATORS FOR PROSTHETIC VALVES
A prosthetic valve, constituted of: a frame movable between a radially compressed and a radially expanded state; and a plurality of leaflets secured to the frame, wherein each of the plurality of leaflets is not flattenable.
Aspects of an expandable sheath can be used in conjunction with a catheter assembly to introduce a prosthetic device, such as a heart valve, into a patient. Such aspects can minimize trauma to the vessel by allowing for temporary expansion of a portion of the introducer sheath to accommodate the delivery apparatus, followed by a return to the original diameter once the prosthetic device passes through. Some aspects can include a sheath with a tubular inner liner wound in a helical scroll slidable configuration. The disclosed sheath is configured to expand from a predetermined rest diameter dT to an expanded diameter de during application of a radial outward force by passage of a medical device through the sheath.
A61L 29/12 - Matériaux composites, c. à d. en couches ou contenant un matériau dispersé dans une matrice constituée d'un matériau analogue ou différent
Various systems and devices are described herein pertaining to expandable sheaths (4400). Sheath aspects are described that include a flexible sheath tip that is expandable and bendable. The sheath includes a radially expandible proximal end and a radially expandable distal end. The sheath tip includes a plurality of layers (4408,4426,4410) that expand to accept a medical device traveling axially and bi-directionally therethrough with minimal deformation of the sheath tip, wherein an intermediate layer (4426) extends distally beyond an inner liner layer (4408) and an elastomeric outer layer (4410) to define a distal end of a tip section, wherein at least the inner liner layer defines a slit (4412) extending distally along at least a portion of the tip section.
A61L 29/12 - Matériaux composites, c. à d. en couches ou contenant un matériau dispersé dans une matrice constituée d'un matériau analogue ou différent
Several heart wall remodeling devices and methods are disclosed. One heart wall remodeling device includes a trimming tool for trimming a line within a patient. The trimming tool includes an actuator for manipulation by a user, a moveable inner shaft coupled to the actuator, and an outer sleeve coupled to the inner shaft. The outer shaft includes a backstop disposed along an inner wall of the outer sleeve and a channel disposed between a first end and a second end of the outer sleeve. The inner shaft includes an inner shaft, a compressible member, and a cutter.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
A catheter (100) has a proximal part, a steerable distal part, and a longitudinal axis therebetween. A wire (110) is advanceable distally out of the catheter, forming a wire loop. A tightening element (116) can be coupled to the wire such that distal sliding of the tightening element over the wire causes contraction of the wire loop and cutting of tissue disposed within the wire loop. A helical needle (140), defining a helical lumen with a suture (144), is configured to be advanced distally out of the catheter and to rotationally extend through, and secure together, the cut tissue edges. The needle and the suture can be configured to extend along the cut edges to suture the cut edges during distal sliding of the tightening element. Other embodiments are also described.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
A61B 17/06 - Aiguilles; Supports ou empaquetages pour aiguilles ou matériaux de suture
Mechanisms are disclosed for securing a catheter (22) in place to facilitate puncturing a hole through a vessel wall. The securing mechanisms include mechanically releasing arms (402) that press against the wall of the vessel (e.g., coronary sinus). The mechanically releasing arms can be advanced out of the catheter. Outside of the catheter, the securing mechanisms angle or curve toward the vessel wall to contact the wall. The more the mechanically releasing arms are advanced, the closer the approach to the wall and the more force placed against the wall to anchor the catheter in place. The mechanically releasing arms can include a plurality of wires that angle or curve toward the vessel wall when deployed, one or more wires that coil away from the catheter to contact the vessel wall when deployed, or a stopper arm with a curved endcap that contacts the vessel wall when deployed.
A61M 25/04 - Dispositifs de maintien en position, p.ex. sur le corps à l'intérieur du corps, p.ex. expansibles
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A61B 17/22 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A sensor implant system comprises a shunt implant comprising a central flow portion configured to maintain an opening through a tissue wall and a sensor implant device. The sensor implant device comprises a shunt body configured to fit at least partially within the central flow portion of the shunt implant and a sensor device coupled to the shunt body.
A sensor implant system comprises a shunt body comprising a central flow portion configured for placement at least partially within an opening of a tissue wall and the sensor implant system comprises a sensor implant device comprising a sensor body. The sensor implant device is configured for placement within the opening of the tissue wall and between the central flow portion of the shunt body and an inner wall of the opening of the tissue wall.
A sensor implant device comprises a sensor body, at least a first sensor component, and one or more anchoring features coupled to the sensor device and configured to anchor within a tissue wall. The one or more anchoring features are configured to assume an unexpanded form during delivery and configured to expand into the tissue wall.
A method and apparatus for determining a subject's autoregulation function state is provided. The method includes: continuously sensing a tissue region of a subject with a tissue oximeter to produce first signals representative of at least one tissue oxygenation parameter during a period of time; continuously measuring a blood pressure level of the subject during the period of time to produce second signals representative of the subject's blood pressure during the period of time; determining a presence of a confounding factor that affects the sensed tissue oxygenation parameter in a manner independent of an autoregulation function of the subject, the determination using the first signals; using the first and second signals to determine an autoregulation function state of the subject when the absence of the confounding factor is determined. The method may include determining an at least one of an LLA or a ULA of a subject's autoregulation function state.
A61B 5/02 - Mesure du pouls, du rythme cardiaque, de la pression sanguine ou du débit sanguin; Détermination combinée du pouls, du rythme cardiaque, de la pression sanguine; Evaluation d'un état cardio-vasculaire non prévue ailleurs, p.ex. utilisant la combinaison de techniques prévues dans le présent groupe et des techniques d'électrocardiographie; Sondes cardiaques pour mesurer la pression sanguine
A61B 5/00 - Mesure servant à établir un diagnostic ; Identification des individus
A61B 5/0205 - Evaluation simultanée de l'état cardio-vasculaire et de l'état d'autres parties du corps, p.ex. de l'état cardiaque et respiratoire
A61B 5/021 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins
A61B 5/1455 - Mesure des caractéristiques du sang in vivo, p.ex. de la concentration des gaz dans le sang, de la valeur du pH du sang en utilisant des capteurs optiques, p.ex. des oxymètres à photométrie spectrale
A mixture (30) is formed into a fiber (40). The mixture includes a polymer (26), and an additive molecule (20) that includes one or more fluorinated end-groups (24). The fiber is incorporated into a fabric or textile (60). Other methods are also described.
D01F 1/10 - Autres agents modifiant les propriétés de ces filaments
A61F 2/00 - Filtres implantables dans les vaisseaux sanguins; Prothèses, c.-à-d. éléments de substitution ou de remplacement pour des parties du corps; Appareils pour les assujettir au corps; Dispositifs maintenant le passage ou évitant l'affaissement de structures corporelles tubulaires, p.ex. stents
A61L 27/00 - Matériaux pour prothèses ou pour revêtement de prothèses
A61L 31/00 - Matériaux pour autres articles chirurgicaux
C08G 18/50 - Polyéthers contenant des hétéro-atomes autres que l'oxygène
A method comprises delivering a first implant to an orifice of a chamber of a heart, anchoring the first implant at the orifice, delivering a sensor device to the orifice, and coupling the sensor device to the first implant.
A sensor implant device includes a sensor device, an anchor base structure secured to the sensor device, a first helical tissue anchor secured to at least one of the sensor device or the anchor base structure, the first helical tissue anchor winding in a first direction, and a second helical tissue anchor secured to at least one of the sensor device or the anchor base structure, the second helical tissue anchor winding in a second direction opposite the first direction.
Balloon compositions that may be used for deployment of implants within a patient's body. The balloons in examples may be utilized for dilating implants and may be coupled to a delivery catheter for an implant. In examples, the balloons may be utilized to dilate other surfaces within the patient's body.
A61L 29/06 - Matériaux macromoléculaires obtenus autrement que par des réactions faisant intervenir uniquement des liaisons non saturées carbone-carbone
A61L 29/14 - Matériaux caractérisés par leur fonction ou leurs propriétés physiques
Mechanisms (400) are disclosed for securing a catheter in place to facilitate puncturing a hole through a vessel wall. The securing mechanisms (400) includes an expanding member (402) that expands when activated to press against the wall of the vessel (e.g., coronary sinus wall (30)). Activation of the securing mechanisms (400) occurs through removal of a restraint (e.g., a cover (401)) or by pushing or pulling a wire. The expanding member (402) may self-expand or may expand due to a spring within a mesh structure. The securing mechanisms activated by pushing or pulling a wire expands due to movement of the wire itself or due to movement of a component attached to the wire and to the anchor member.
A61M 25/04 - Dispositifs de maintien en position, p.ex. sur le corps à l'intérieur du corps, p.ex. expansibles
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 17/12 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical
Components for a valve treatment systems are disclosed. Valve treatment systems can include a delivery system for an implantable device. The delivery system can include one or more of clasp control components slidably disposed on a catheter handle, a control element for opening and closing the implantable device, a catheter assembly with features to reduce friction with another catheter assembly, grips for attaching catheter assemblies to clamps, catheter assemblies with features that stiffen or provide variable stiffness, and catheter assemblies with one or more steering control lumens incorporated into a reinforcement layer.
A multiple location pressure sensing device for use with a prosthetic heart valve delivery assembly is disclosed in several examples. As one example, a prosthetic heart valve delivery assembly with a multiple location pressure sensing device can include a delivery apparatus, a guidewire, and a delivery apparatus. The example also includes a first pressure sensor configured to be positioned near an inlet end of a prosthetic heart valve and a second pressure sensor configured to be positioned near an outlet end of the prosthetic heart valve, wherein the first and second sensor are configured to measure a pressure gradient across the prosthetic heart valve.
A method for providing autoregulation function information is provided. The method includes: a) continuously sensing a tissue region with a tissue oximeter during a period of time, the sensing producing first signals representative of at least one tissue oxygenation parameter; b) continuously measuring a blood pressure level during the period of time using a blood pressure sensing device, the measuring producing second signals representative of the blood pressure level of the subject; c) evaluating the at least one tissue oxygenation parameter using the first signals and the blood pressure level using the second signals, relative to one another; d) producing a recent profile of autoregulation data using the first and second signals from a recent portion of the period of time; e) producing a historical profile of autoregulation data using the first and second signals from a historical portion of the period of time.
A61B 5/02 - Mesure du pouls, du rythme cardiaque, de la pression sanguine ou du débit sanguin; Détermination combinée du pouls, du rythme cardiaque, de la pression sanguine; Evaluation d'un état cardio-vasculaire non prévue ailleurs, p.ex. utilisant la combinaison de techniques prévues dans le présent groupe et des techniques d'électrocardiographie; Sondes cardiaques pour mesurer la pression sanguine
A61B 5/00 - Mesure servant à établir un diagnostic ; Identification des individus
A61B 5/021 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins
A61B 5/1455 - Mesure des caractéristiques du sang in vivo, p.ex. de la concentration des gaz dans le sang, de la valeur du pH du sang en utilisant des capteurs optiques, p.ex. des oxymètres à photométrie spectrale
35.
EXPANDABLE PROSTHETIC HEART VALVE WITH FLATTENED APICES
A prosthetic heart valve including a radially expandable and compressible annular frame is disclosed. The frame includes a plurality of interconnected struts defining a plurality of rows of cells arranged between an inflow end and an outflow end of the frame, the interconnected struts comprising a plurality of outflow struts defining the outflow end and a plurality of inflow struts defining the inflow end. The frame further includes a plurality of apex regions formed at the inflow end and the outflow end, each apex region curving between two angled strut portions and forming one of the outflow struts or one of the inflow struts with the two angled strut portions. Each apex region has a narrowed width and a length that extends along at least 25% of a total length of the outflow strut or inflow strut, the narrowed width smaller than a width of the two angled strut portions.
A fabric having a honeycomb weave pattern formed by biocompatible fibers. The fabric in examples may be heat treated to increase a thickness of the fabric. The fabric may be compliant, and compressible, to allow for cushioning within a patient's body. For example, the fabric may be applied to a prosthetic valve to cushion a portion of the prosthetic valve. Friction bodies are further disclosed.
D03D 13/00 - Tissus caractérisés par la disposition particulière des fils de chaîne ou de trame, p.ex. avec fils de trame incurvés, avec fils de chaîne discontinus, avec fils de chaîne ou de trame en diagonale
A delivery catheter is in various examples configured to deliver an anchoring device to a native valve annulus of a patient's heart, where the anchoring device can better secure a prosthesis at the native annulus. The delivery catheter in examples may be configured to deflect in a ventricular direction during deployment of an anchoring device. Examples of docking coil sleeves and docking coils are disclosed herein.
A61F 2/966 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure avec un mouvement longitudinal relatif entre la gaine extérieure et la prothèse, p.ex. utilisant une tige poussoir
Disclosed herein are implantable medical devices comprising a textile material comprising a first material and a second material having different stretchability and flexibility, where the first and the second materials are at least partially superposed and coupled to each other. The medical devices of the current disclosure can be implantable prosthetic valves. The valves of the present disclosure provide for a reduced crimped profile and improve PVL sealing. In addition, disclosed herein are methods of making the implantable medical devices.
A stabilizing base includes one or more legs and a platform attached to the one or more legs. One or more of a height of the platform relative to an operating table, a position of the platform along a width of the operating table, a position of the platform along a length of the operating table, and an angular position of the platform relative to the operating table can be adjusted.
This disclosure is directed to prosthetic heart valves having elongated sealing members. As one example, a prosthetic heart valve comprises an annular frame, a leaflet assembly comprising a plurality of leaflets, and a skirt assembly comprising an inner skirt, an outer skirt, and/or a third skirt. The frame is radially compressible and expandable between a radially compressed state and a radially expanded state and comprises a plurality of apices at an inflow end. The skirt assembly forms a pocket at the inflow end of the frame that creates extra space between the inflow end of the frame and the skirt assembly when the frame is in the radially expanded state. This pocket allows the apices at the inflow end of the frame to move towards an inflow end of the pocket when the frame is radially compressed to the radially compressed state without protruding through the skirt assembly.
A hemodynamic monitoring system monitors arterial pressure of a patient and provides a warning to medical personnel of nociception of the patient. The system includes a hemodynamic sensor that produces hemodynamic data representative of an arterial pressure waveform of the patient. A hardware processor in the system is configured to execute nociception detection software code to perform waveform analysis of the hemodynamic data to determine a plurality of signal measures. Detection input features are extracted from the plurality of signal measures by the processor that are indicative of a nociception event of the patient. A nociception score representing a probability of the nociception event of the patient is determined from the detection input features. A sensory alarm is invoked in response to the nociception score satisfying a predetermined detection criterion.
A61B 5/021 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins
G16H 50/30 - TIC spécialement adaptées au diagnostic médical, à la simulation médicale ou à l’extraction de données médicales; TIC spécialement adaptées à la détection, au suivi ou à la modélisation d’épidémies ou de pandémies pour l’évaluation des risques pour la santé d’une personne
A61B 5/00 - Mesure servant à établir un diagnostic ; Identification des individus
A61B 5/0215 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par des moyens introduits dans le corps
A61B 5/022 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par application d'une pression pour fermer les vaisseaux sanguins, p.ex. contre la peau; Ophtalmodynamomètres
A61B 5/024 - Mesure du pouls ou des pulsations cardiaques
A61B 5/029 - Mesure du débit de sang à la sortie du cœur, p.ex. volume éjecté par minute
A61B 5/08 - Dispositifs de mesure pour examiner les organes respiratoires
A sensor implant device includes a shunt body that forms a fluid conduit, a first anchor structure associated with a first axial end of the shunt body, and a first sensor-retention structure associated with a second axial end of the shunt body, the first sensor-retention structure being configured to hold a first sensor device in a sensing position in which a sensor transducer of the first sensor device is disposed at least partially radially outside of a channel area of the fluid conduit.
A sensor implant device can include a shunt body that forms a fluid conduit, a first anchor structure associated with a first axial end of the shunt body, a second anchor structure associated with a second axial end of the shunt body, and a first sensor device coupled to the first anchor structure, the first anchor structure being configured to hold the first sensor device in a sensing position over a channel area of the fluid conduit.
An implantable prosthetic valve may comprise a valve body having a proximal end, a distal end, an outer surface, and an inner surface facing a flow channel, and a skirt including a first level forming at least a portion of the outer surface of the valve body and configured to be thromboresistant and a second level forming at least a portion of the outer surface of the valve body and configured to allow tissue ingrowth with the second level. A plurality of prosthetic valve leaflets may be positioned within the flow channel and extend inward from the inner surface of the valve body.
A system for delivering a guidewire through a heart valve comprises a delivery catheter configured to pass through a blood flow pathway of a heart, an inner catheter having an inner lumen, a guidewire configured to pass through the inner lumen of the inner catheter, and a positioning device crimped onto an outer surface of the inner catheter, wherein. The delivery catheter is configured to receive the inner catheter, guidewire, and positioning device and is configured to prevent expansion of the positioning device. The positioning device is configured to expand upon removal from the delivery catheter.
A delivery apparatus for delivering a prosthetic implant includes a handle and a shaft assembly having an inner shaft and an outer shaft. A carriage member is disposed within a cavity of the handle and coupled to the outer shaft. An annular groove to receive a seal member is defined within the carriage member by a proximal end of the outer shaft and a stepdown shoulder formed within the carriage member. The inner shaft extends through a lumen of the outer shaft and includes one or more fluid ports that fluidly connect a lumen of the inner shaft to the lumen of the outer shaft. The implant is coupled to the inner shaft by a frame connector having a recess to receive a connector tab of the implant. The recess includes an undercut wall that transfers tensile force applied to the connector tab to radial force on the connector tab.
A61F 2/95 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes
A61F 2/962 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure
A61F 2/966 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure avec un mouvement longitudinal relatif entre la gaine extérieure et la prothèse, p.ex. utilisant une tige poussoir
A sensor implant device includes a shunt body that forms a fluid conduit, the fluid conduit having an axis, a first anchor structure associated with a first end of the shunt body, and a first sensor device coupled to the first anchor structure such that a sensor transducer of the first sensor device projects into a channel area defined by a radial boundary around the axis of the fluid conduit, the radial boundary being defined by the fluid conduit.
Apparatuses, systems, and methods for prosthetic valves. Embodiments of prosthetic valves may be directed to sealing flow at an implantation site, which may comprise a native valve. Embodiments may be configured to conform to a shape of a native valve, which may be a non-circular shape. Embodiments may include a frame having portions coupled together by one or more rotation joints. Embodiments may include a crescent shaped frame. Embodiments may include a construction of a frame having integral portions. Embodiments may include a portion of a prosthetic valve having a micropattern applied to the prosthetic valve. One or more microbeads may be utilized in embodiments. A construction of a prosthetic valve utilizing a support ring may be provided.
Disclosed are embodiments of replacement heart valves. Embodiments may include a collapsible and expandable frame comprising rows of cells. The frame may include a plurality of axial connection portions extending between top ends and bottom ends of the cells, wherein each axial connecting portion is shaped to bend for accommodating temporary changes in cell height during non-uniform compression of the replacement heart valve. Frames having these features are advantageous when advancing a replacement heart valve through a funnel-shaped compression tool. The axial connection portions are sufficiently flexible to accommodate changes in frame shapes during compression while also being sufficiently resilient for enhancing the structural integrity of the frame in the fully deployed state. The replacement heart valves are preferably dual-frame heart valves, wherein the axial connection portions form a portion of an inner frame and wherein an outer frame is provided for engaging tissue and forming a seal.
A delivery system includes a suture attachment mechanism for maintaining a connection to a heart valve after initial deployment, thereby allowing recapture of the heart valve if desired. A plurality of suture portions is provided along a distal end portion of the delivery system, each suture portion having a first end fixed to the delivery system and a second end releasably coupled to a retention member on the delivery system. A knob on a handle of the delivery system is actuated for causing the second end of each suture portion to be released from its respective retention member, thereby allowing the suture portions to be decoupled from the heart valve. The suture portions are located only along a distal end portion of the delivery system for improving reliability and consistency.
A sensor implant device includes a shunt body that forms a fluid conduit, a first anchor structure associated with a first end of the shunt body, a second anchor structure associated with a second end of the shunt body, a sensor device coupled to the first anchor structure, and an antenna coupled to the second anchor structure.
Devices and methods for delivering and deploying cardiac anchors, such as for an atrioventricular heart valve regurgitation reduction implant. An active puncturing tool integrated into an anchor deployment system more accurately insures the location of anchor deployment. One lead of an EKG system connects to a rear end of a puncturing needle which has a conductive tip. Operating the EKG system along with one or both of fluoroscopy and echocardiography systems enables accurate placement of the needle tip. Once located, one or more anchors are deployed from or around the needle. One grappling-hook style anchor has sutures in tension that hold embedded tines from withdrawing from the tissue.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
53.
METHODS TO FOLD AND FORM DELIVERY SYSTEM BALLOONS TO REDUCE THE DEPLOYED THV HEIGHT ASYMMETRY
The present embodiments relate generally to devices, systems, and methods for dilating implants utilizing dilation devices. An example includes a dilation device for an implant. The dilation device includes an inflatable body having a proximal end and a distal end, and a central body positioned between the proximal end and the distal end and having a length. The central body is configured to press an inner surface of the implant to dilate the implant. The inflatable body includes at least one outer inflatable body fold radius of curvature greater than or equal to one half a thickness of the inflatable body.
A61F 2/958 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes ballons gonflables pour insérer les stents ou les endoprothèses déployables couvertes
The present invention relates to implantable prosthetic devices, and more particularly, to 3D- shaped skirts having various coatings and/or configurations thereof.
Methods and assemblies for attaching leaflets to a frame of a prosthetic heart valve using a connecting skirt are disclosed. As one example, a prosthetic heart valve can include an annular frame comprising a plurality of struts and a valvular structure mounted within the frame and comprising a plurality of leaflets. A cusp edge portion of each leaflet can be connected to the frame by a connecting skirt, where each connecting skirt comprises a central portion and opposing side base portions on opposite sides of the central portion that are connected to each of and disposed between the frame and the cusp edge portion of the leaflet and each connecting skirt can further comprise side extension portions that extend outward from the cusp edge portion of the leaflet and across struts of the frame that are disposed between cusp edge portions of two adjacent leaflets.
Apparatuses, systems, and methods for holding prosthetic implants. The systems in certain embodiments may be for use in holding prosthetic implants prior to implantation within a patient's body and prior to coupling to a delivery apparatus used to implant the prosthetic implant within the patient's body. Certain embodiments disclosed herein may relate to apparatuses, systems, and methods for prosthetic implant preparation prior to implantation.
A61F 2/95 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes
A61F 2/00 - Filtres implantables dans les vaisseaux sanguins; Prothèses, c.-à-d. éléments de substitution ou de remplacement pour des parties du corps; Appareils pour les assujettir au corps; Dispositifs maintenant le passage ou évitant l'affaissement de structures corporelles tubulaires, p.ex. stents
An expandable sheath including an elongated inner member defining a central lumen extending therethrough. The inner member includes a first circumferential portion including a first and second longitudinal edges, and a second circumferential portion extending between the first and second longitudinal edges. The wall thickness of the first circumferential portion is greater than the wall thickness of the second circumferential portion. The elongated inner member is configured to transition from an unexpanded configuration to an expanded configuration in response to a radially outward force on an inner surface of the central lumen. In the unexpanded configuration, the elongated inner member is creased proximate the first and second longitudinal edges into a folded configuration such that the second circumferential portion is positioned at least partially radially inward of the first circumferential portion.
An implantable device is configured to be positioned within a native heart valve to allow the native heart valve to form a more effective seal. The implantable device includes a first cover portion and a second cover portion. The second cover portion has a lower coefficient of friction than the first cover portion.
A61B 17/12 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical
Disclosed herein are implantable prosthetic valves having outer sealing member comprising a bulge in the expanded configuration. The bulge can be configured to provide sealing against native anatomy when the valve is implanted and to assist in minimizing a paravalvular leakage. In addition, disclosed herein are methods of making the prosthetic valves.
Systems and methods for remodeling of tissue, such as heart tissue. In some configurations, the systems and methods are directed toward remodeling of the mitral valve of a patient. The systems and methods can include a first tissue anchor, a second tissue anchor, a suture that extends between the tissue anchors, and a suture lock that secures the suture relative to at least one of the tissue anchors or fixes a length of the suture. The systems and methods can also include a suture trimmer that can trim an excess portion of the suture. In some configurations, the suture lock is reversible to allow for iterative adjustments of the remodeling. In some configurations, the tissue anchors include a feature or features, such as one or more barbs, to inhibit removal of the tissue anchor from an implanted position within tissue.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
An implantable device or implant is configured to be positioned within a native heart valve to allow the native heart valve to form a more effective seal. In some implementations, the implantable device or implant, or one or more portions thereof, can be configured to expand and/or contract. For example, the implantable device or implant can narrow during delivery and expand on implantation on the native heart valve.
A delivery system comprises a catheter configured to be delivered through a blood flow pathway of a heart and an implant configured to maintain an opening in a tissue wall to allow blood flow through the opening and into the blood flow pathway and be delivered via the catheter. The implant is at least partially composed of a flexible material to allow the implant to bend with the catheter.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A method of shunting blood involves forming a first opening in a wall of a first blood vessel and a wall of a second blood vessel, anchoring a first port of a compliant fluid container to the wall of the first blood vessel such that the first port provides access between the first blood vessel and the second blood vessel through the first opening, and placing a body of the compliant fluid container within the second blood vessel.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A container configured to receive a dock assembly therein for packaging is disclosed. The container can include: a base defining an engagement surface configured to receive the dock assembly; a lid configured to releasably engage with the base such that at least a portion of the dock assembly is disposed between the base and the lid; and a dock holder affixed to the container and configured to receive a first portion of the dock assembly comprising two or more adjacent coils thereon. The dock holder can comprise a protrusion configured to engage the first portion of the dock assembly and space a second portion of the dock assembly away from the dock holder.
A prosthetic heart valve can have one or more hermetic layers. The inner skirt and/or the outer skirt can comprise one or more hermetic layers, or the entire valve frame can be encapsulated within one or more hermetic layers. Each hermetic layer can be substantially nonporous or can have pores therein that are sized to discourage cellular ingrowth. The hermetic layer can prevent ingrowth of surrounding native tissue, thereby reducing pannus formation on the prosthetic leaflets. Alternatively or additionally, shapes of the leaflets of the valvular structure of the prosthetic valve and/or the coupling of the leaflets to the valve frame can be selected to avoid the incidence of stasis when implanted at a relatively low pressure gradient hemodynamic location. Such a prosthetic heart valve may reduce the risk of thrombosis.
Embodiments of a nosecone for a transcatheter delivery apparatus are disclosed. The nosecone can include a distal portion and a proximal portion. A longitudinal axis can extend from a distal end of the distal portion to a proximal end of the proximal portion. The proximal portion can have a shoulder region adjacent the distal portion of the nosecone and a body region proximal to the shoulder region. An outer surface of the nosecone can have a cross-sectional profile taken along the longitudinal axis of the nosecone. The cross-sectional profile of the body region can have a convex shape when viewed from a centroid of the body region.
A sealing frame surrounds a radially-outer surface portion of a valve frame of a prosthetic heart valve. Both the valve frame and the sealing frame are radially collapsible and expandable between respective compressed and expanded configurations. The sealing frame has a first axial end coupled to the valve frame at its inflow end, and a second axial end coupled to the valve frame at a location between its inflow and outflow ends. The sealing frame also has an intermediate portion between the first and second axial ends that projects radially outward when the valve and sealing frames are in their expanded configurations. The sealing frame displaces an outer skirt of the prosthetic heart valve radially outward and urges the outer skirt into contact with surrounding native tissue, thereby reducing or avoiding paravalvular leakage. In some examples, the sealing frame can be formed of a shape memory material.
Docking stations are configured to retain and position a transcatheter heart valve in a circulatory system. The docking stations can comprise an expandable frame. The docking stations can include an enlarged first end portion having a first outer radial portion with a first major lateral dimension, an enlarged second end portion having a second outer radial portion with a second major lateral dimension, and a narrowed central waist portion having an inner radial portion with a third major lateral dimension smaller than the first and second major lateral dimensions. A retaining portion is at least partially defined by at least one of the first and second end portions, and a valve seat is at least partially defined by the waist portion. The docking station can be configured to adapt a native tricuspid valve to accept a smaller transcatheter heart valve.
Methods and systems for providing a consistent flow of fluid through lumens of a delivery apparatus are disclosed. As one example, a delivery apparatus can include an outer shaft configured to retain a prosthetic implant in a delivery configuration, an inner shaft disposed within the outer shaft and configured to interface with an end of the prosthetic implant and move axially relative to the outer shaft, and a sleeve shaft disposed within the outer shaft and configured to cover the prosthetic implant in the delivery configuration. In some examples, the inner shaft can include one or more openings defined therein that extend between an inner surface and an outer surface of the inner shaft and that are configured to fluidly couple an inner lumen of the inner shaft with a lumen disposed between the outer surface of the inner shaft and an inner surface of the sleeve shaft.
A delivery catheter is in various embodiments configured to deliver an anchoring device to a native valve annulus of a patient's heart, where the anchoring device can better secure a prosthesis at the native annulus. A sheath catheter may be utilized to deliver the delivery catheter and a catheter for deploying a prosthetic valve to the anchoring device.
A61F 2/95 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes
A61F 2/962 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure
71.
CATHETERS FOR IMPLANTS AND MEDICAL PROCEDURES AND METHODS OF USE THEREOF
A delivery catheter is in various embodiments configured to deliver an anchoring device to a native valve annulus of a patient's heart, where the anchoring device can better secure a prosthesis at the native annulus. The delivery catheter may include a flexible portion configured to form a spiral shape in embodiments.
A61F 2/962 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure
72.
APPARATUS AND METHODS FOR REDUCING PARAVALVULAR LEAKAGE
This disclosure is directed to a docking device for a prosthetic heart valve. The docking device includes an inflow end, an outflow end, a support structure disposed between the inflow end and the outflow end, and an expandable sleeve. The support structure includes inflow and outflow sections that are configured to be positioned on inflow and outflow sides, respectively, of a native heart valve. The outflow section includes a first portion, a second portion, and a third portion, wherein the first portion is disposed closer to the inflow section than the second portion, and wherein the third portion is disposed between the first and second portions. The expandable sleeve may extend at least 100 degrees over the first portion of the outflow section of the support structure. Additionally, or alternatively, the first portion of the outflow section of the support structure may have a different geometry than the third portion.
The present embodiments relate generally to devices, systems, and methods for an inflatable device. A system may include an interior inflatable body configured to inflate in response to receiving fluid. The system may include an exterior inflatable body at least partially surrounding the interior inflatable body and configured to inflate when the interior inflatable body inflates and apply an expansion force to the surface to dilate the surface, the exterior inflatable body having a distal portion, a proximal portion, and one or more openings at the distal portion configured to allow the fluid within the interior inflatable body to escape the exterior inflatable body when the interior inflatable body is punctured or bursts.
A61F 2/958 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes ballons gonflables pour insérer les stents ou les endoprothèses déployables couvertes
The present invention relates to systems and methods for estimating prosthetic valve expansion diameter, and in particular, for system and methods for analyzing images acquired during prosthetic valve expansion, to identify structural components of the valve, determine dimensions thereof, and estimate at least one outer diameter of the prosthetic valve, and potentially a plurality of outer diameter along different axial positions of the prosthetic valve.
Certain examples of the disclosure concern a docking device for securing a prosthetic valve at a native valve. The docking device includes a coil having a plurality of helical turns when deployed at the native valve, an expandable member extending radially outwardly from the coil and being movable between a radially-compressed/axially-elongated state and a radially-expanded/axially-foreshortened state, and a cover member surrounding an outer surface of the expandable member. A distal end portion of the cover member and a distal end portion of the expandable member are fixedly coupled to the coil via a distal suture including a plurality of knots and a plurality of wraps. A proximal end portion of the expandable member is fixedly coupled to a proximal end portion of the cover member. The proximal end portion of the expandable member and the proximal end portion of the cover member are axially movable relative to the coil.
An introducer sheath can be used to safely introduce a delivery apparatus into a patient's vasculature (e.g., via the femoral artery). It is advantageous to visualize the placement of an introducer sheath within the vasculature using an imaging system. The sheaths disclosed herein include radiopaque features that assist with imaging without sacrificing the low profile, expandability, and other advantageous aspects of the introducer sheath.
The present invention relates to implantable prosthetic devices, such as prosthetic heart valves, provided with a plurality of protective covers over various components of the frame or commissural support members of the valves.
Embodiments of a delivery apparatus for implanting a prosthetic valve are disclosed. The delivery apparatus can include a handle, a first shaft extending from a distal end of the handle, a second shaft extending through a lumen of the first shaft and the handle, and a gripper located proximal to a proximal end of the handle. A proximal end of the second shaft can be connected to the gripper, and the gripper can be axially moveable relative to the handle such that axial movement of the gripper causes corresponding axial movement of the second shaft relative to the first shaft. The gripper can have a bottom surface that is substantially coplanar with a bottom surface of the handle.
Apparatuses, systems, and methods for prosthetic valves. Embodiments of prosthetic valves may be directed to improvements in anchoring to an implantation site and/or sealing flow at an implantation site, which may comprise a native valve. Embodiments may be configured to conform to a shape of a native valve, which may be a non-circular shape. Such native valves may include native valve annuli having oval shapes and/or shapes that include one or more recesses. Improvements in anchoring to implantation sites are disclosed as well.
A medical implant comprises a central flow portion having a first network of struts forming two or more cells, a first set of anchoring arms, and a second set of anchoring arms. The two or more cells are arranged linearly and extend from the first set of anchoring arms to the second set of anchoring arms.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
81.
EXPANDABLE SHEATH INCLUDING REVERSE BAYONET LOCKING HUB
A sheath locking system comprising an introducer locking hub 30 comprising a hub body 32 defining a locking channel 38 for engaging a corresponding guide 31 on a sheath locking sleeve 28. The sheath locking sleeve removably coupled to the introducer locking hub via engagement between the guide and the locking channel. The sheath locking sleeve is movable between an unlocked position where the sheath locking sleeve is rotationally and axially movable with respect to the introducer locking hub, and a locked position where the sheath locking sleeve is axially fixed with respect to the introducer locking hub.
Various stabilizing systems and devices are described for holding and maneuvering medical devices. Some systems and devices include one or more of a base plate, a carriage, and a clamp, or a combination thereof. The base plate can be attached to one or more tables. The carriage can be moveably attached to the base plate or can be integrally formed with the base plate. The carriage can receive one or more clamps. The one or more clamps can be moveably attached to the carriage or the base and configured to receive one or more medical devices.
Apparatuses, systems, and methods for prosthetic valves are described. Embodiments of prosthetic valves may include a sealing body configured to allow a leaflet anchor to move radially inwardly or pass through a wall of the sealing body. Alternatively, or in addition, the sealing body may be configured to move radially outwardly past the leaflet anchor for contacting surrounding tissue. This pass through feature allows the sealing body to form a tight seal against the surrounding native tissue in the event wherein a leaflet anchor fails to fully capture a native leaflet. Additional embodiments for improved sealing, anchoring and valve function may include modular valve systems and prosthetic valves including anchors for coupling to heart structures, such as chordae, trabeculae, or papillary muscles. Embodiments may also include prosthetic valves including anchors adapted for engaging calcification of a patient's native valve.
An implantable sensor device includes a sensor- support substrate, a microelectromechanical systems (MEMS) pressure sensor device mounted to the sensor- support substrate, a transduction medium applied over the pressure sensor device, and a biocompatibility layer applied over the transduction medium
Methods and systems for attaching a radiopaque marker to a prosthetic heart valve to indicate a location of a commissure of the prosthetic heart valve are disclosed. As one embodiment, a prosthetic heart valve can include a frame including a plurality of struts forming a plurality of cells of the frame arranged between an inflow end and an outflow end of the frame, a plurality of leaflets arranged within the frame, at least one commissure comprising an attachment member arranged across a selected cell of the plurality of cells of the frame and attached to struts of the frame forming the selected cell, and commissure tabs of two adjacent leaflets coupled to the attachment member, and a radiopaque marker arranged on the attachment member of the commissure. The marker is configured to indicate a location of the commissure of the prosthetic heart valve.
Methods and systems for rotationally aligning a commissure of a prosthetic heart valve with a commissure of a native valve are disclosed. As one embodiment, a delivery apparatus can include a first shaft that is configured to rotate around a central longitudinal axis of the delivery apparatus; a second shaft extending through the first shaft and having a distal end portion extending distally beyond a distal end portion of the first shaft; an inflatable balloon coupled to the distal end portion of the first shaft; and a shoulder arranged within the balloon and a radiopaque marker mounted on or embedded within the shoulder at a location spaced radially outward from an outer surface of the distal end portion of the second shaft. The marker can be reflection asymmetric along an axis that is parallel to the central longitudinal axis.
A61F 2/966 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure avec un mouvement longitudinal relatif entre la gaine extérieure et la prothèse, p.ex. utilisant une tige poussoir
A prosthetic valve comprises a frame assembly having a first opening at an inflow portion of the frame assembly and a second opening at an outflow portion of the frame assembly, a first sensor device situated at the inflow portion of the frame, and a second sensor device situated at the outflow portion of the frame. Each of the first sensor device and the second sensor device is configured to sense a physical parameter and provide a sensor signal. The prosthetic valve further comprises a transmitter assembly configured to receive the sensor signals from the first sensor device and the second sensor device and wirelessly transmit a transmission signal based at least in part on the sensor signals.
Apparatuses, systems, and methods for crimping implants and for device preparation. The apparatuses in certain embodiments may comprise crimping devices for compressing an implant prior to deployment to a portion of a patient's body. Support bodies may be utilized to reduce possibility of damage to the implant during the crimping process. Other bodies may be utilized to improve accuracy of a crimped position of the implant on the delivery apparatus.
Balloon covers for a delivery apparatus for a prosthetic valve are disclosed. As one embodiment, a balloon cover includes first and second shell members that are configured to matingly engage with each other, each of the first and second shell members including a first portion and a second portion, the second portion having a larger width than the first portion. The first portions of the first and second shell members define a first cavity configured to receive a distal end portion of the delivery apparatus and at least a portion of an inflatable balloon mounted on the distal end portion of the delivery apparatus. The second portions of the first and second shell members define a second cavity configured to receive a positioning device mounted on the distal end portion of the delivery apparatus, proximal to a valve mounting portion of the distal end portion of the delivery apparatus.
A61F 2/958 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes ballons gonflables pour insérer les stents ou les endoprothèses déployables couvertes
A61F 2/966 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure avec un mouvement longitudinal relatif entre la gaine extérieure et la prothèse, p.ex. utilisant une tige poussoir
A sensor-retention structure includes a sensor-support arm configured to hold a sensor device and a stabilizer structure associated with the sensor- support arm and configured to project away from the sensor- support arm and provide stabilizing support for the sensor- support arm.
An implantable prosthetic device can include a frame movable between a radially compressed configuration and a radially expanded configuration, and a valvular structure. The frame can have an inflow orifice, an outflow orifice, and one or more commissure windows. The valvular structure can include a plurality of leaflets, each leaflet having a main body with an inflow edge, an outflow edge, and a pair of opposing tabs. Each tab can be paired with an adjacent tab of an adjacent leaflet to form a commissure tab assembly, and each commissure tab assembly being coupled to a respective commissure window. Each tab can extend from the main body at an angle such that a radially outer edge of the tab corresponds to a draft angle of the frame.
Aspects of an expandable sheath can be used in conjunction with a catheter assembly to introduce a prosthetic device, such as a heart valve, into a patient. Such aspects can minimize trauma to the vessel by allowing for temporary expansion of a portion of the introducer sheath to accommodate the delivery apparatus, followed by a return to the original diameter once the prosthetic device passes through. Some aspects can include various configurations of the sheath that comprise an elongated tube having a disclosed composition that can form an outer jacket or a strain relief jacket or can be used as the outer layer of the sheath. Aspects of the present expandable sheath can avoid the need for multiple insertions for the dilation of the vessel and reduce the push force needed for passage of the medical device, thus offering advantages over prior art introducer sheaths.
An anchoring device that can be positioned within a native valve, such as the native mitral valve, to secure a replacement prosthetic valve in place. The anchoring device can comprise a docking station formed of an elastic tube-like member defining a generally coiled shape. The docking station can have an atrial or stabilization turn, a leading or encircling turn, and a central region. In many embodiments, the docking device possess a plurality of cuts on opposing sides of the tube-like member to allow biasing of the member.
Assembly methods for installing a valvular structure to an expandable annular frame of a prosthetic heart valve are described. The valvular structure has a multiple leaflets, each with a pair of tabs. Each tab of the leaflet has upper and lower portions. Commissures formed by paired tabs of adjacent leaflets are coupled to corresponding commissure windows to support the valvular structure within the frame. Each commissure window has upper and lower openings separated from each other by a crossbar and may have an H-shape. The upper and lower tab portions extend through the upper and lower openings, respectively, of the corresponding commissure window. One or more wedge members coupled to the tab portions can prevent the leaflet tab from passing back through the commissure window, thereby retaining the valvular structure to the annular frame.
A61F 2/958 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes ballons gonflables pour insérer les stents ou les endoprothèses déployables couvertes
95.
SYSTEMS AND METHODS FOR HEART VALVE LEAFLET REPAIR
An implant (100) includes an interface (110), and a wing (120) that is coupled to the interface and has a contact face. A catheter (40) is transluminally advanceable to a chamber (6) of a heart of a subject and houses the implant. A delivery tool comprises a shaft (60) and a driver (70). Via engagement with the interface, the shaft is configured to (i) deploy the implant out of the catheter such that, within the chamber, the wing extends away from the interface; and (ii) position the implant in a position in which the interface is at a site in the heart, the wing extends over the first leaflet toward the opposing leaflet, and the contact face faces the first leaflet. The driver is configured to secure the implant in the position by using an anchor to anchor the interface. Other embodiments are also described.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
96.
PROSTHETIC IMPLANT SYSTEMS FOR DIAMETER ADAPTATION
Prosthetic implant systems for diameter adaptation may be provided. The systems may provide for increased flexibility of providing implants having various diameters, and reducing expense associated with keeping a stock of implants at various sizes. Embodiments as disclosed herein may utilize a prosthetic implant having a docking frame that may be configured to expand to a range of working diameters. The docking frame may dock with a valve frame that may be configured to expand to a working diameter that is more closely tailored to the diameter of the implantation site. The valve frame may have a lesser range of expansion of working diameters than the docking frame.
Embodiments disclosed herein may be directed to devices, systems, and methods for addressing leaflets within a patient's body, including displacement of such leaflets. The leaflets may be of a native heart valve, or may be of a prosthetic heart valve that has been previously implanted within the patient's body. The leaflets may be displaced to reduce the possibility of the leaflets blocking access to structures within the patient's body, which may comprise cardiac structures such as coronary ostia, for example. As such, a reduced possibility of maladies caused by blockage of the cardiac structures may result.
The present disclosure relates to automated systems, devices, and methods of sewing a target device such as a prosthetic implant device. The systems and methods include forming a stitch on the target device, adjusting a thread coupled to a needle used to form the stitch so that the thread is clear of (e.g., does not interfere with) a path of the needle, and applying a targeted tension to the thread to tension the stitch on the target device. The suturing process can also include providing different targeted tensions during formation of the stitch. The suturing process can also include providing different targeted tensions at different stages of the formation of the stitch to aid in forming the stitch, to clear the needle path of the thread, and/or to hold the stitch in place in preparation for the next stitch.
The present embodiments relate generally to devices, systems, and methods for expansion of an expandable implant. A system may include a first inflatable body having a first outer diameter when in an inflated state. The system may include a second inflatable body positioned adjacent to the first inflatable body and having an outer surface configured to apply an expansion force to the expandable implant and having a shape that tapers downward in a direction towards the first inflatable body to a narrow portion having a second outer diameter that is less than the first outer diameter when the second inflatable body is in an inflated state.
A release mechanism for a delivery apparatus and associated methods for operating the release mechanism are disclosed. As one example, a handle portion of the delivery apparatus can include a release mechanism configured to adjust a linear position of a component of the delivery apparatus. The release mechanism can include a threaded drive screw including one or more retaining elements arranged at a proximal end of the drive screw and one or more grooves forming a helical threaded portion of the drive screw that each extend from a corresponding retaining element to a distal end of the drive screw, the drive screw coupled to the component; and a rotatable knob surrounding and coaxial with the drive screw, the knob including one or more teeth arranged at a proximal end of the knob, each tooth configured to interface with a corresponding retaining element and groove of the drive screw.
A61F 2/95 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes
A61F 2/966 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure avec un mouvement longitudinal relatif entre la gaine extérieure et la prothèse, p.ex. utilisant une tige poussoir
A61M 25/01 - Introduction, guidage, avance, mise en place ou maintien en position des cathéters
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